Prevalence of metallo-β-lactamase producing Pseudomonas aeruginosa and Acinetobacter species in intensive care areas in a tertiary care hospital

Abstract

A total of 39 non-duplicate isolates of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter species isolated from blood and endotracheal secretions were tested for metallo-β-lactamase (MBL) production by modified-EDTA disc synergy and double disc synergy tests. The prevalence of MBLs was 33.33% by both the above tests. All patients with MBL-positive isolates were multidrug resistant and had multiple risk factors like > 8 days hospital stay, catheterization, IV lines, previous antibiotic use, etc. These were risk factors for imipenem resistance also. The overall mortality in MBL-positive patients was 46.15%.

blaIMP and blaVIM mediated carbapenem resistance in Pseudomonas and Acinetobacter species in India

“…Over the past few years MBL producing isolates have emerged worldwide and are associated with outbreaks in health-care settings. They cause serious infections such as bacteremia and ventilator associated pneumonia, particularly in patients admitted to the ICU [14,17]. The CLSI has not recommended any standardized phenotypic methods for screening MBL in clinical isolates.…”

“…They have a broad spectrum of activity and are stable to hydrolysis by most of the beta lactamases, including the extended spectrum beta lactamases (ESBL) and the Amp C beta lactamases. In recent years there has been an increase in carbapenem resistance among Gramnegative bacteria in the Indian subcontinent [12,13,14]. Resistance mechanisms include lack of drug penetration (i.e., porin mutations and efflux pumps) and/or carbapenem hydrolysingbetalactamase enzymes [2,15,16].…”

Detection of metallo-beta-lactamase producing Pseudomonas aeruginosa in intensive care units

“…5 Emergence of MBL producing P. aeruginosa in intensive care units (ICUs) is alarming and reflects overuse of carbapenems. 6 There is intense selection pressure, due to high usage of broad spectrum antibiotics in ICUs. This results in eradication of competitive flora and subsequent selection of multidrug-resistant strains.…”

Carbapenem-Resistant Non-Glucose-Fermenting Gram-Negative Bacilli: the Missing Piece to the Puzzle

“…This is not surprising, since MBLs confer broad-spectrum antibiotic resistance; however, it is important to note that the prevalence of MBL expression in CR-NF varies. In India alone, the rate of reported MBL expression among CR-NF varies from ϳ20 to 80% (27). Most worrisome is the potential for resistance gene transfer from CR-NF to other Gram-negative organisms and vice versa.…”